Approximately 80% of Americans will experience back pain at some point in life with sufficient severity to cause absence from work.
Pain in the back or neck area can be acute, meaning it occurs suddenly and intensely, or chronic, meaning it can last for weeks, months, or even years. The pain can be continuous or intermittent.
Back and Neck Pain: Symptoms
Symptoms associated with back pain include:
- Pain that is aggravated by coughing or sneezing
- Pain or numbness that travels down one or both legs
- Pain that awakens you from sleep
- Swelling, stiffness and limited motion
- Difficulty with bowel movements or with passing urine
- Pain that is accompanied by loss of urination or bowel control
If you experience any of these symptoms you should see a doctor immediately because they could indicate nerve damage or other serious medical problems.
Back pain and associated symptoms vary depending on the underlying cause. Some of the more common causes of back pain include:
- Strain: Lumbar strain is essentially a stretching injury to the ligaments, tendons, and/or muscles of the lower back. This injury can occur as the result of overuse, improper use, or trauma. The most prominent symptom is pain or discomfort in the lower back with onset occurring after an event that has stressed the lumbar tissues.
- Herniated disk: Disk herniation is a rupture of the material that surrounds the intervertebral disk. This rupture may cause pressure on nearby nerves, resulting in severe pain occurring at the point of rupture. If the bulging disc presses on a spinal nerve, the pain may spread to the area of the body that is served by that nerve.
- Sciatica: Approximately 40% of the population experiences sciatica at some point in their lives, as a result of injury or pressure to the sciatic nerve. The largest and longest nerve in the body, the sciatic nerve runs from the lower part of the spinal cord, down the back of the leg, to the foot. A characteristic symptom of sciatica is a sharp or burning pain that emanates from the lower back or hip, often following the path of the sciatic nerve to the foot.
- Spinal stenosis: Spinal stenosis is a narrowing of the spinal canal that causes compression of the spinal nerve cord. Pressure on the back nerves causes back pain and can also cause numbness, pain, and weakness in the legs. The pain gets worse after the person stands for a long time.
- Radiculopathy: Pain and other symptoms such as numbness, tingling, and weakness in the arms or legs often indicate a problem with the nerve roots, referred to as radiculopathy.
Back and Neck Pain: Diagnosis
Diagnosing back pain can be difficult. Your doctor will start by reviewing your medical history and conducting a comprehensive physical examination that includes evaluation of your motor and sensory functions. The evaluation may involve moving your legs in various positions to test for nerve root irritation or disk herniation.
X-rays may be required for patients whose symptoms suggest cancer, infection, inflammation, pelvic or abdominal disease, or bone fractures. Your doctor may also request further studies, such as computed tomography (CT) or magnetic resonance imaging (MRI) scans, electromyography, myleography or discography to aid in diagnosis.
Back and Neck Pain: Treatment
The most common treatments for back pain include pain medications, anti-inflammatory drugs, steroid injections, applied heat or cold, rest, traction, and support.
Your physical therapist may suggest massage therapy or certain exercises and activities to stretch and strengthen your lower back muscles and help prevent further episodes.
The majority of back pain sufferers will not require surgery, but surgical procedures can provide relief to patients who do not respond to non-surgical treatment. These surgical procedures include:
- Diskectomy: removal of a herniated disk to relieve pressure on a nerve root.
- Laminectomy: removal of the lamina to make more room for the nerves.
- Spinal Fusion: placing a bone graft between two or more vertebrae, causing the vertebrae to grow together, or fuse.
Back and Neck Pain: Resources
National Chronic Pain Outreach Association (NCPOA)
P.O. Box 274
Millboro, VA 24460
National Institute of Arthritis and Musculoskeletal and SkinDiseases Information Clearinghouse
1 AMS Circle
Bethesda, MD 20892-3675
Tel: 877-22-NIAMS (226-4267)
American Academy of Orthopedic Surgeons/American Association of Orthopedic Surgeons
6300 North River Road
Rosemont, IL 60018
American Academy of Neurological and Orthopedic Surgeons
10 Cascade Creek Lane
Las Vegas, NV 89113
American Academy of Physical Medicine & Rehabilitation
9700 West Bryn Mawr Avenue, Suite 200
Rosemont, IL 60018-5701